Individual
MRS. TERESA ANN DETLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
314 W 1ST ST, OGALLALA, NE 69153-2520
(308) 284-8481
Mailing address
PO BOX 915, OGALLALA, NE 69153-0915
(308) 284-8481
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
—
—
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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